David Cullinane (Waterford, Sinn Fein) | Oireachtas source

To follow on from the theme of the last discussion, I had a similar experience to Mr. Gloster when I was appointed health spokesperson for my party. Unfortunately, I started at the height of the pandemic, which was a difficult situation for everybody. I spent about ten months meeting hospital managers, front-line healthcare professionals and people in the Department and HSE. I was talking to as many people as possible to understand what we are doing right in healthcare, and we are doing many things right, but also where we can improve, as everybody wants to improve the health service. That notion Mr. Gloster has of identifying quickly what best practice is and then mandating that it be done is exactly what needs to happen. That is the leadership we need across the health service. There are many examples in community, primary and acute care of good practice not being implemented across the system, so I 100% support that approach. It would be a significant cultural shift at the top of the HSE if that was done at pace.

I want to pick up on some of the themes of Mr. Gloster's contribution and opening statement. In the latter he focused on access, urgent care and used all the right words, including outcomes, affordability, capacity and effectiveness. He then talked about access and performance, timely implementation and public confidence. Mr. Gloster rightly said beds are not the only solution. I did a lot of analysis myself and tried to get my head around what was really driving the chaos, if we want to call it that, in emergency departments. The right care in the right place at the right time that Sláintecare promised stems from the idea that if people cannot get access to a GP or primary care or cannot get support in the community for neurorehabilitation from the integrated care programme for older persons, ICPOP, or community health teams, they end up going to hospital. We therefore need to invest in all those areas.

However, we equally have a problem with capacity in hospitals. If Mr. Gloster is going to bring hospital managers together, that is exactly the right thing to do. It is about holding them to account but also, I imagine, supporting them and enabling them to do what needs to be done. That could be a game changer as well. Those managers will look to Mr. Gloster and rightly say they have been screaming for beds, surgical theatre capacity and diagnostic capacity in our hospitals and it takes too long for decisions to be made and for things to be done.

I spoke to Mr. Gloster earlier about beds. Coincidentally, I only got the parliamentary question reply back ten minutes after we had our contribution, so I want to come back to Mr. Gloster on that one. As he said, it is not just about beds, but they are important. I refer to the budget in October 2020 which was to be delivered in 2021. I remember we had a robust discussion at this committee about the Estimates following that budget. A figure of 1,156 beds, plus 72 from the national service plan to make 1,228, were to be delivered in 2021. A total of 970 of those beds were delivered to the end of 2022 with 207 planned to be delivered this year, so three years in we are still waiting for those beds to be delivered. Today I have found out 49 of those beds will now be delivered in 2024. How in God's name could it take four years to deliver beds? Mr. Gloster is talking about pace and delivery, public confidence, timely implementation and performance. We funded and resourced the HSE to deliver 1,228 beds in 2021 and we now see some of them will not now be delivered until 2024, all while we have people waiting for 12 hours or more in emergency departments. In Cork, elderly people are waiting more than 24 hours on average. It is unacceptable. The hospital managers are screaming out for more beds. Will Mr. Gloster give me some insight into this from his perspective? He cannot be held accountable for any of it yet, but he is the HSE now so he must start answering some of those questions. Will he give me some understanding of why it has taken so long to deliver those beds?